PhD Scientific Days 2025

Poster Session II. - O: Health Sciences

Psychometric Testing of the ICECAP-A in Patients with Coeliac Disease: a Comparative Analysis with EQ-5D-5L

Name of the presenter

Angyal Mária Mercédesz

Institute/workplace of the presenter

Semmelweis University

Authors

M. Mercédesz Angyal 1,2¹, Peter L. Lakatos 3,4², Valentin Brodszky 2³, Fanni Rencz 2³

1: 1-Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, Budapest, Hungary, 2-Department of Health Policy, Corvinus University of Budapest, Budapest, Hungary, 3- McGill University Health Centre
2: 3- McGill University Health Centre, Montreal General Hospital, Canada, 4- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
3: Department of Health Policy, Corvinus University of Budapest, Budapest, Hungary

Text of the abstract

Introduction: Coeliac disease (CD) is a food-related autoimmune condition that primarily affects the small intestine, with a global prevalence of 1%. Due to various symptoms and the strict gluten-free diet (GFD), the deterioration in patients’ health-related quality of life (HRQoL) is well-documented.

Aim: This study aims to assess the psychometric properties of the ICEpop CAPability measure for Adults (ICECAP-A) in patients with CD and compare its performance with the EQ-5D-5L.

Methods: An online cross-sectional survey was conducted among 312 adult CD patients in Hungary, who completed both the ICECAP-A and EQ-5D-5L. The following psychometric properties were assessed: ceiling, convergent validity with the Gastrointestinal Symptom Rating Scale (GSRS) and Satisfaction with Life Scale (SWLS) and known group validity. Mean ICECAP-A and EQ-5D-5L index values were computed using the Hungarian value sets [1,2]. To allow for comparison with the Hungarian population norms [3-4], ICECAP-A index values were also calculated using the UK value set [5], as this was used in the Hungarian population norm study.

results: Mean age was 36 years (range 18-80), and 70% were female. On the ICECAP-A, 51% (attachment) to 81% (stability) reported limitations in their capabilities. In comparison, 2% (self-care) to 41% (pain/discomfort) of patients reported problems on the EQ-5D-5L. No ceiling effect was observed on the ICECAP-A (7%), in contrast with a high ceiling effect on the EQ-5D-5L (39%). Mean index values of ICECAP-A were lower than the EQ-5D-5L (0.85 vs. 0.92). ICECAP-A correlated strongly with SWLS (rs=0.685), moderately with EQ-5D-5L (rs=0.485) and weakly with GSRS (rs=-0.314). The ICECAP-A differentiated between known groups by general health status and symptoms with large effect sizes (0.189-0.379). More limitations were reported among CD patients in multiple ICECAP-A items than the general population, particularly in stability (81% vs. 48%) and achievement (78% vs. 57%). Patients reported worse capability well-being across almost all age groups compared to the general population (mean ICECAP-A index: 0.76-0.86 vs. 0.84-0.92).

Conclusion: This is the first study to validate the ICECAP-A in patients with CD. The ICECAP-A is a valid measure in this population, sensitive to specific symptoms and health status.